Factors Affecting Cerebral Oxygenation in Hemodialysis Patients: Cerebral Oxygenation Associates with pH, Hemodialysis Duration, Serum Albumin Concentration, and Diabetes Mellitus

Background: Although cerebral regional oxygen saturation (rSO2) is significantly lower in hemodialysis (HD) patients than that in healthy controls, investigations on cerebral oxygenation in peritoneal dialysis (PD) patients are limited. We aimed to confirm the cerebral oxygenation status and identify the factors affecting cerebral rSO2 in PD patients. Methods: Thirty-six PD patients (21 men and 15 women; mean age, 62.8 ± 12.7 years) were recruited. In addition, 27 healthy volunteers (17 men and 10 women; mean age, 43.5 ± 18.8 years) were recruited as a control group. Cerebral rSO2 was monitored at the forehead using an INVOS 5100c oxygen saturation monitor. Results: Cerebral rSO2 was significantly lower in PD patients than that in healthy controls (57.0 ± 7.3% vs 68.9 ± 8.6%, p < 0.001); moreover, cerebral rSO2 was significantly correlated with natural logarithm (Ln)-PD duration ( r = −0.389, p = 0.019) and serum albumin concentration ( r = 0.370, p = 0.026) in a simple linear regression analysis. Multivariable linear regression analysis was performed using variables that showed a significant correlation and p < 0.20 (serum creatinine, serum sodium, Ln-C-reactive protein, and dosage of erythropoiesis-stimulating agent) with the cerebral rSO2. Cerebral rSO2 was independently associated with Ln-PD duration (standardized coefficient: −0.339) and serum albumin concentration (standardized coefficient: 0.316). Conclusions: Cerebral rSO2 was significantly affected by the PD duration and serum albumin concentration. Further prospective studies are needed to clarify whether preventing a decrease in serum albumin concentration leads to the maintenance of cerebral oxygenation in patients undergoing PD.

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Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2016/1269706 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Po-Chung Cheng ◽

Shang-Ren Hsu ◽

Yun-Chung Cheng

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Serum Albumin ◽

Medical Center ◽

Albumin Concentration ◽

Cerebrovascular Event ◽

Serum Albumin Concentration ◽

Cross Sectional

Objective.This study examined the association between serum albumin concentration and ketosis risk in hospitalized individuals with type 2 diabetes mellitus (T2DM).Methods. A retrospective cross-sectional study was conducted at a medical center in Taiwan. Inclusion criteria were endocrinology ward inpatients exceeding 21 years of age, with preexisting diagnosis of T2DM, and blood glucose above 13.9 millimoles per liter (mmol/L) at admission. Individuals without measurement of serum albumin, urine ketone, or hemoglobin A1C, or harboring active infection, myocardial infarction, cerebrovascular event, cirrhosis, malignancy, or overt proteinuria were excluded. Using serum albumin concentration below 3.0 grams per deciliter to define hypoalbuminemia, 151 hypoalbuminemic cases and 104 normoalbuminemic controls were enrolled. The presence of ketones in urine established ketosis.Results. The prevalence of ketonuria was 48% in hypoalbuminemic subjects compared to 30% in normoalbuminemic controls (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.26–3.57;P=0.004). Moreover, among the 156 subjects with serum beta-hydroxybutyrate measurement in addition to urine ketone, 33% of the hypoalbuminemic individuals had ketonemia exceeding 3 mmol/L compared to 19% of those with normoalbuminemia (OR: 2.12, 95% CI: 0.99–4.48,P=0.051).Conclusions. Serum albumin concentration is inversely associated with ketosis risk in hospitalized individuals with T2DM.

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A Risk Analysis of Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis

Peritoneal Dialysis International ◽

10.1177/089686080502500413 ◽

2005 ◽

Vol 25 (4) ◽

pp. 374-379 ◽

Cited By ~ 78

Author(s):

Kai Ming Chow ◽

Cheuk Chun Szeto ◽

Chi Bon Leung ◽

Bonnie Ching-Ha Kwan ◽

Man Ching Law ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Peritoneal Dialysis ◽

Confidence Interval ◽

Serum Albumin ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Hazard Ratio ◽

Albumin Concentration ◽

Serum Albumin Concentration ◽

Increased Risk

Objective We studied the clinical characteristics that influence the risk of dialysis-related peritonitis complication in incident Chinese patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods A single center, retrospective, observational cohort study was carried out to examine the risk factors of developing a first episode of dialysis-related peritonitis. Results Between 1995 and 2004, 246 incident CAPD patients were recruited for analysis. During the study period of 897.1 patient-years, 85 initial episodes of peritonitis were recorded. The median peritonitis-free time for diabetic subjects was significantly worse than for nondiabetic subjects (49.0 ± 10.5 vs 82.3 ± 12.6 months, p = 0.0019). The difference was due mainly to a higher likelihood of developing peritonitis with gram-negative organisms in patients with diabetes mellitus ( p = 0.038). Low serum albumin concentration was also associated with worse peritonitis-free survival. There was a nonsignificant trend toward an increased risk for peritonitis in the group of patients with cerebrovascular disease. According to multivariate Cox proportional hazards model for the analysis of time to first peritonitis episode, the two independent risk factors were presence of diabetes mellitus and initial serum albumin concentration. In particular, diabetes mellitus was associated with a hazard ratio of 1.50 and a 95% confidence interval of 1.05 – 2.40 ( p = 0.030) to develop an initial peritonitis. Lower serum albumin level at the start of CAPD was a significant predictor of peritonitis, with hazard ratio of 1.67 for every decrease of 10 g/L, and 95% confidence interval 1.08 – 2.60 ( p = 0.021). Conclusions Our results confirm the susceptibility of diabetic CAPD and hypoalbuminemic patients to peritonitis, and highlight the role of further studies in reducing this complication.

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Serum Albumin Concentrations: Who Needs Them?

Annals of Pharmacotherapy ◽

10.1177/106002809202600916 ◽

1992 ◽

Vol 26 (9) ◽

pp. 1134-1138 ◽

Cited By ~ 7

Author(s):

Brian L. Erstad

Keyword(s):

Serum Albumin ◽

Data Extraction ◽

Institutional Setting ◽

Albumin Concentration ◽

Serum Albumin Concentration ◽

General Applicability ◽

Factors Affecting ◽

Number Of Factors ◽

Study Selection ◽

Patient Prognosis

OBJECTIVE: To examine the multiple factors that influence serum albumin concentrations and to discuss settings in which the monitoring of such concentrations provides clinically useful information. DATA SOURCES: Original investigations, review articles, books, and abstracts published in English. STUDY SELECTION: Studies pertaining to factors affecting serum albumin concentration were chosen based on general applicability. Recommendations related to the appropriate monitoring of albumin concentrations were based on studies performed in the clinical setting with direct applicability to patient care. DATA EXTRACTION: Data on factors affecting serum albumin concentration were extracted from studies that resulted in similar conclusions regardless of assay technique. Appropriate indications for albumin monitoring were derived from studies demonstrating direct clinical relevance. DATA SYNTHESIS: A number of factors may influence serum albumin concentration and ultimately affect interpretation of the concentration. Serum albumin concentrations generally are useful in the institutional setting shortly after admission or preoperatively to determine patient prognosis. Albumin concentrations have limited merit for predicting the free fractions of various hormones, electrolytes, and drugs. When used as an indicator of nutritional support, albumin concentrations are most helpful when measured over longer periods in relatively stable patients. CONCLUSIONS: Serum albumin determinations should be limited to those situations in which the concentrations are likely to provide clinically useful information. Such situations are limited.

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Comparison of vascular access type in pediatric hemodialysis patients with respect to urea clearance, anemia management, and serum albumin concentration

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2004.10.017 ◽

2005 ◽

Vol 45 (2) ◽

pp. 303-308 ◽

Cited By ~ 41

Author(s):

Deepa H. Chand ◽

Michael Brier ◽

C. Frederic Strife

Keyword(s):

Serum Albumin ◽

Vascular Access ◽

Hemodialysis Patients ◽

Albumin Concentration ◽

Serum Albumin Concentration ◽

Urea Clearance ◽

Pediatric Hemodialysis ◽

Anemia Management

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Serum Albumin Concentration and Cognitive Impairment

Current Alzheimer Research ◽

10.2174/1872209197471563128 ◽

2009 ◽

Vol 999 (999) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

David J. Llewellyn

Keyword(s):

Cognitive Impairment ◽

Serum Albumin ◽

Albumin Concentration ◽

Serum Albumin Concentration

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Low serum albumin concentration is associated with increased risk of osteoporosis in postmenopausal patients with rheumatoid arthritis

Journal of Orthopaedic Science ◽

10.1016/j.jos.2021.08.018 ◽

2021 ◽

Author(s):

Yoshio Nagayama ◽

Kosuke Ebina ◽

Hideki Tsuboi ◽

Makoto Hirao ◽

Jun Hashimoto ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Serum Albumin ◽

Albumin Concentration ◽

Serum Albumin Concentration ◽

Increased Risk ◽

Low Serum

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Serum Albumin and Future Risk of Hip, Humeral, and Wrist Fractures in Caucasian Men: New Findings from a Prospective Cohort Study

Medical Principles and Practice ◽

10.1159/000499738 ◽

2019 ◽

Vol 28 (5) ◽

pp. 401-409 ◽

Cited By ~ 2

Author(s):

Setor K. Kunutsor ◽

Ari Voutilainen ◽

Michael R. Whitehouse ◽

Samuel Seidu ◽

Jussi Kauhanen ◽

...

Keyword(s):

Serum Albumin ◽

Area Under The Curve ◽

Fracture Prevention ◽

Albumin Concentration ◽

Serum Albumin Concentration ◽

Baseline Serum ◽

Increased Risk ◽

New Findings ◽

Caucasian Men ◽

Low Serum

Objective: Low serum albumin concentration is associated with poor health outcomes, but its relationship with the risk of fractures has not been reliably quantified. We aimed to assess the prospective association of serum albumin with the risk of fractures in a general population. Subjects and Methods: Baseline serum albumin concentrations were measured in 2,245 men aged 42–61 years in the Kuopio Ischemic Heart Disease study. Hazard ratios (HRs) (95% confidence intervals) were calculated for incident fractures. Results: A total of 121 fractures (hip, humeral, or wrist) were recorded during a median follow-up of 25.6 years. The risk of fractures increased linearly below a serum albumin concentration of ∼48 g/L. The age-adjusted HR (95% CI) for fractures per 1 standard deviation lower serum albumin was 1.24 (1.05–1.48). On further adjustment for several conventional and emerging risk factors, the HR was attenuated to 1.21 (1.01–1.45). Comparing the bottom versus top quartile of serum albumin levels, the corresponding adjusted HRs were 2.48 (1.37–4.48) and 2.26 (1.23–4.14). The association of serum albumin with fracture risk did not differ substantially according to age, body mass index, blood pressure, physical activity, alcohol consumption, socioeconomic status, inflammation, prevalent diseases, and smoking. Serum albumin at a threshold of 41.5 g/L demonstrated an area under the curve of 0.5850. Conclusion: In middle-aged Caucasian men, low serum albumin is associated with an increased risk of future fractures. The potential relevance of serum albumin concentrations in fracture prevention and prediction deserves further evaluation.

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